State of Wonder

Ann Patchett is becoming one of my favorite authors. This is the second book I've read by her and while Bel Canto is still my favorite, she does not disappoint with State of Wonder either. I enjoyed this book from the moment Dr. Singh starts her journey into the Amazon. One of her colleagues has died out there while helping Dr. Singh's former professor conduct research. Dr. Singh is assigned the task of finding out what exactly happens. This becomes a journey of self-discovery, self-reflection, and ethical dilemmas.

I would say more, but I want people to read it so I'm not going to give anything away. There are some significant plot twists and unanswered questions in the book as well that will keep you thinking for a little while after you finish reading. Ms Patchett has left me, once again, wanting more (in a good way). I will be taking a look at her other books now to see what else I can get my hands on.

Gulp

This was one of the non-fiction books on my "want to read" list this year. I'll admit you have to have a general interest in the GI tract or medical topics. It's so well-written that even the layman can understand it. That's why I enjoyed it so much. Even though I could understand a book full of medical terms, I enjoy it when an author can write about complex topics at a more palatable level (bad pun intended). The book follows the amazing GI system from top to bottom. From the first bite of food to that final trip to the bathroom. So, yes, this book is not for people easily grossed out by things like spit, vomit, and bowel movements. Since I work at a hospital with patients who have some of the ailments discussed here, I was completely into it! This was probably one of the more enjoyable medical reads for me in a long time.

Since it does cover topics that might make some people gag, I won't go into detail about it. It's definitely not for everyone, but if you have a curious mind that is not turned off by bodily functions, I think it's a great read!

Five Days at Memorial

I visited New Orleans only one time in my life and that happened to be about two months prior to Hurricane Katrina. I lived in NYC at the time and went down there for a music festival. When I got back to NYC, I couldn't stop talking about the pralines and beignets. Then Hurricane Katrina happened and as I watched the news coverage, I kept thinking about how I was just down there and how lovely it had all been. Like most of the United States, I saw the horrible conditions, rooftop rescues, extreme flooding, and deep despair. I wasn't a nurse at that time. I wouldn't start nursing school until about a year later. I was still working in the photography industry. So I didn't really give much thought to what the hospitals endured. Only after being a nurse now for a little over five years do my thoughts immediately go to hospitals and medical staffing in times of crises.

So when I heard the author of this book on NPR, I was all in. I had been so focused on the atrocity that was the Superdome, that I had completely missed this story about euthanasia in hospitals and nursing homes. This particular book hones in on Memorial Hospital in particular where there were an inordinate amount of dead patients found after the storm. Investigators dug further and the story that surfaced was one that is so tangled and speculative that you really hope it's not true. The author does, in my opinion, an excellent job of being objective leaving you to come to your own conclusion. For five days after the storm hit, patients and medical staff were essentially stranded in the hospital with no clear communication regarding rescue. When the generators failed and there was still limited to no rescue in sight, choices became desperate. Some patients were found with toxic amounts of morphine and midazolam in their system.  The question is whether or not those drugs were purposefully used to hasten death or were they used to provide comfort and death was a side effect?

There are so many layers to medical decisions that it's hard to pass judgment if you were not physically there yourself or if you were not the person in charge of the decision. After reading this book, I continue to think heavily about medical ethics, living wills and quality of life issues. The best part of the story was the first section where the five days are described in detail. The second part of the book is more about the legal and ethical challenges faced when attempting to prosecute physicians and nurses for suspected euthanasia. I found the book fascinating and really enjoyed it. If you are not a medical professional, you may find yourself bored or uninterested in the complexities, but I think it's a good read for anyone.

The Good Nurse

I am a nurse by trade so I was sickened by this story and I have a lot to say about it.  It's the true story of a nurse named Charles Cullen who, over the course of his sixteen-year career, murdered and injured hundreds of patients. This man was very disturbed and also had multiple known suicide attempts.  He would attempt suicide just enough to get some medical attention and maybe go to a psych facility, but never enough to actually get the job done.  It was always a cry for help, because if he were serious he would have just shot himself in a strategic location.  Being a nurse, he would have known what to do. This man clearly needed a LOT of psych help that he did not receive.

I was uncomfortable reading this story because I just cannot fathom doing harm to a patient.  There were multiple times in the story when I would pause and just think "How can he be okay doing this to people?" and "What the hell is wrong with this dude?" Honestly, when I have to give a medication at work, I'm breaking out the calculator and making sure that the dose is right several times before I even give it.  We even have rules in place where certain medications have to be checked by more than one nurse so multiple people check the dose several times before it reaches the patient.  This guy was BLATANTLY putting insulin in normal saline bags, loading syringes with overdoses of digoxin and injecting the heart medication right into the patient without a second thought, overdosing patients on medications that paralyze the body.  It was crazy!  I have always had a difficult time understanding mental illness.  I understand that the body and brain can experience such severe stress that one can 'just snap', but this guy was cold and calculating.

What really made me angry was that hospitals were not held accountable for their hiring practices.  All this was going on from the late 1980s until around 2003 in New Jersey and Pennsylvania, so it's fairly recent history.  He was able to continue to get jobs!  He worked at at least NINE DIFFERENT HOSPITALS. I started nursing in 2008. At that time we had to get fingerprints, a background check, a drug test and more.  At the time, I thought all that testing was standard for nursing. Come to find out, it was all implemented after this guy was caught and convicted!  Maybe if these protocols were in place back then he would have been either caught earlier or not allowed to enter the field of nursing in the first place.  However, with his mental illness, he may have still found a way to harm people.

As a side note, there is currently no 'national' nursing license. Nursing is regulated state by state.  This is a problem. I am a huge proponent of a national nursing license.  Charles Cullen was able to go from New Jersey to Pennsylvania because each state requires a different license so he could easily hold a license in both states and they may or may not communicate with each other about his questionable history. A lot of nurses have multiple licenses, especially if you live in a 'tri-city' area that covers multiple states like NY-CT-NJ or DE-MD-VA or NJ-DE-PA.  Even I hold a license in two states because I live in a 'tri-city' area.

The book is very well written with accurate sources and footnotes that cite those sources. The author does an excellent job of making the reader think about several hot button topics like mental illness, hospital transparency, patient rights, patient safety, hospital safety, and hiring practices.  I thought more about my career while reading this book than I have since being a nurse.  I've never been exposed to the underbelly of it and I think that's why it made me uncomfortable and incredulous.  That's why it stuck with me. I love my job and can't imagine anyone being in this field and behaving the way this guy did. This book will stick with me for a while.  If you're in the health field, I highly recommend it.  Even if you're not in the health field, I think it would still be an interesting read.  Not good for the beach or vacation, because you may be sad or enraged afterwards.  Save this one for Fall/Winter.

Writer, M.D.

One would think I would be wary of medical books since I work in the medical field, but I usually love them.  This is a collection of non-fiction and fiction medical writing.  I found that I actually enjoyed the non-fiction writing more than the fiction.  I think it's just because I could relate to some of the non-fiction scenarios.  Reality can be more entertaining than fiction when it comes to medical stories. There were about three non-fiction stories that I felt "blah" about.  The rest were pretty good and held my attention.  The fiction stories were not as strong, although at least two of them were memorable and I found myself wishing the story was longer. Overall, if you have an interest in medical writing, this isn't necessarily an extraordinary "must-read", but it's a solid choice.

Playing God in the Nursery

This book was mentioned at one of our patient management meetings when we were discussing NICU care.  So of course I had to pick it up because, having worked in a NICU for a little over 4 years, I have a big interest in it.  The disclaimer is that this book was written in the 80s when hospitals still had smoking lounges and words like "defective", "crippled",  "retarded", and "handicapped" were acceptable.  So if words like that will offend you, this may not be the medical history book you want to read.  The book does a very good, detailed job of describing the evolution of NICU care and the consequences of that care.  It raises the very same ethical questions that we are still dealing with to this day.  I found it interesting, but only if you have worked in a NICU or have a keen interest in NICUs and ethics. Otherwise you may be too bored to care.

The Immortal Life of Henrietta Lacks

It only took me FOREVER to finish this wonderful book because school gets in the way of my REAL education.  Anyway, this book was very well written and really interesting to read.  I can see why it's a bestseller!

Baby ER

I enjoyed this piece of "medical journalism".  If you are a NICU nurse and read this, keep in mind it is 10years old and things are a little different now.....for instance, it's not uncommon for a hospital to have nitric now.  Apparently when the book was written there really were only a few hospitals with approval for it. Who knew?

The Female Brain

A very interesting look at the female brain through the various stages of life (adolescent, young woman, mother, grandmother, etc..). I recognized myself as well as friends of mine in many of the examples.